Knee joint effusion

Case contributed by Dr Henry Knipe

Presentation

Fall with twisting injury.

Patient Data

Age: 50
Gender: Male
X-ray

No fracture or malalignment. Small knee joint effusion. 

Annotated image

Annotated image demonstrating signs of knee joint effusion. 

Case Discussion

Knee joint effusions are common and can occur in a variety of settings (e.g. trauma, degenerative change, infection or inflammation).

Knee joint effusions are only reliably seen on lateral projections. The following signs have been reflected as the most sensitive:

  • rounded soft-tissue density in the suprapatellar recess
  • loss of normal posterior fat plane of the quadriceps tendon
  • fat pad separation sign: reflects the base of the suprapatellar bursa, which sits between peri-articular fat pads
    • >10mm is diagnostic
    • 5-10mm is equivocal and other signs of knee joint effusion are needed
    • <5mm means no joint effusion
  • presence of lipohaemarthrosis

There are certainly other signs of knee joint effusions such as anterior displacement of the patella, but these are only reliably seen on large (>20 mL) joint effusions. 

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Case information

rID: 32559
Case created: 2nd Dec 2014
Last edited: 26th Nov 2015
Inclusion in quiz mode: Included

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